Oral Aspirin Does Not Up FIT Test Sensitivity for ID'ing CRC

Administration of a single dose of oral aspirin prior to fecal immunochemical testing does not increase test sensitivity for detecting advanced colorectal neoplasms, according to a study published in the May 7 issue of the Journal of the American Medical Association.

Hermann Brenner, M.D., M.P.H., from the German Cancer Research Center in Heidelberg, and colleagues conducted a randomized trial in 14 gastroenterology practices and four hospitals in Germany involving 2,422 men and women aged 40 to 80 years who were scheduled for colonoscopy. Participants were randomly assigned to administration of either a single tablet containing 300 mg aspirin or placebo two days before fecal sampling for the fecal immunochemical test.

The researchers identified advanced neoplasms in 10.5 percent of participants, including 0.4 and 10.1 percent with colorectal cancer and advanced adenoma, respectively. In the aspirin and placebo groups, sensitivity was 40.2 and 30.4 percent, respectively, at a cutoff of 10.2-µg Hb/g stool (difference, 9.8 percent; 95 percent confidence interval, −3.1 to 22.2 percent; P = 0.14) and 28.6 and 22.5 percent, respectively, at a cutoff of 17-µg Hb/g stool (difference, 6.0 percent; 95 percent confidence interval, −5.7 to 17.5 percent; P = 0.32).

"This trial was designed to detect a 24 percent absolute increase in sensitivity and was not adequately powered to detect small differences that may nevertheless be clinically meaningful," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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